Going To College With Type 1 Diabetes: Accommodations + Resources

Starting college is a big life transition—it marks a huge step from childhood to young adulthood, giving you more independence than you might’ve ever had before. And while that’s exciting, it can also be nerve-wracking, especially when you live with a chronic illness like type 1 diabetes (T1D). 

When you live with T1D, there are more layers of planning to consider, from legal paperwork to diabetes supply logistics to figuring out who on campus actually needs to know. Rest assured—that’s why we’ve put together this guide for you, so you can mark one thing off your list and focus on enjoying your college years as much as possible!

The legal landscape: from Section 504 to the ADA

If you had a Section 504 plan in high school, it doesn’t automatically follow you to college. Colleges still have to provide accommodations under Section 504 and the Americans with Disabilities Act (ADA), but the responsibility shifts. In K-12, your school had to identify your needs and act on them. In college, it’s on you to register with the Office of Disability Services (ODS) and request what you need directly.

A 504 plan is a formal accommodations plan built around Section 504 of the Rehabilitation Act of 1973, a law that protects students with disabilities at any school that receives federal funding. 

For a student with T1D, it typically covers things like:

• Checking blood glucose, using a CGM or insulin pump and eating or drinking in class without being questioned.
• Extra time on a test or a retake option if a high or low blood sugar interrupts it.
• Bathroom and water breaks whenever they’re needed.
• A safe place to store insulin and supplies, like a mini-fridge or the nurse’s office.
• A clear plan for who to call and what to do during a diabetes emergency.

Register early in the semester, before you’re in the middle of a diabetes-related crisis. Once you’re registered, ask about specific accommodations like testing flexibility for hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar), housing options such as a mini-fridge for insulin storage and any other adjustments that fit your situation.

Register for accommodations, even if you’re well-managed with T1D

Registering with your school’s Disabilities Services office is your legal right. 

Doing so ensures you create an on-the-record plan that protects you for things like:

• The option to postpone or retake a test or assignment affected by unmanageable blood sugar levels.
• Keeping your professors informed so you can eat or drink in class during a low and check your blood glucose monitor (BGM), continuous glucose monitor (CGM) or insulin pump without being questioned.
• Early class or housing registration, meal plan adjustments and roommate options.
  

Even if you’ve never had a severe issue that required assistance from someone else with your diabetes before or have needed support, opting into your disability services at college offers you protection just like health insurance does. It’s there when you need it. 

You can never be too careful! Opt in. You will be doing new things in a new environment with new people—you know better than anyone that in life with T1D, the unknowns and things you can’t anticipate can throw you a curveball quickly.

Find out which office handles accommodations before you show up, and bring documentation like prescriptions or a letter from your healthcare provider (HCP) confirming your T1D diagnosis and management needs. This can save you from a headache later! Just get it done.

Remember: Your diabetes doesn’t have to feel “ugly” or unmanageable to register—anyone, regardless of how well they manage, should register if they have T1D. The longer you’ve lived with diabetes, the easier it is to normalize the ups and downs that are truly abnormal. Your diabetes is “bad enough” to register, period.

Before you move in

If you live with T1D, two key things are worth locking down, on top of other general non-diabetes-related college checklists, before the semester starts.

The first two things you should do before you move away from home and into your new college space, whether you’re just 30 minutes away or many hours away, are:

• Set up care: ask your regular HCP near your hometown for a referral near campus or see if they can do a telehealth appointment while you’re at school. You can also try to coordinate visits back home around your appointments, but explore other options first.
  
• Stock up: pack a 90-day supply of insulin, sensors, infusion sites, etc.—whatever you regularly use to manage diabetes—since shipping delays and insurance snafus happen. It can even take you some time to switch pharmacies if you need to. This is especially important the further away you’ll be from home. Don’t count on getting your prescription a few days after you submit it when you’re going through a big move like this. Plan! Coordinate with your parents and HCPs.

8 things you should do once you’re on campus

Once you’re settled in, you can start digesting this new chapter of your life and take steps to stay even more prepared and protected while at school with T1D.

Here are some things you should consider acting on as you get settled on campus:

1. Find your school’s health services center and get familiar with the staff. It’s good to know where to go if you need help and to have some familiar faces. 
2. Locate the nearest hospital and 24-hour pharmacy, and give your HCP that pharmacy’s address and phone number for prescription renewals. 
3. Note your dining hall hours so meal timing and insulin dosing aren’t a guessing game. Build a new routine that brings predictability to your diabetes management, which it thrives on. 
4. Talk to your resident advisor (RA) and roommate about your T1D. How much you share is up to you, but it’s worth covering the basics, such as what a low looks like, where you keep fast-acting carbs or glucagon and who to call in an emergency. 
5. Keep an eye out for other students or staff wearing pumps or CGMs or carrying insulin pens, and consider starting a group chat or meetup community for people with T1D on campus. It never hurts to have some diabuddies on campus! They might be looking for connections, too. It never hurts to ask. The worst they can say is “no thanks.” Or maybe you’ll find a community that already exists and can join. 
6. Email your professors the Professor’s Guide to Type 1 Diabetes if you feel comfortable, or use points from it to chat with them during office hours or after class so you feel safe and comfortable in their class.
   
   Here’s an email template you can use to initiate the conversation respectfully and clearly with your professors:
   
   “Hello (Professor/Dr. Name),
   
   My name is (Your Name), and I am in your (name of class) class. I wanted to let you know that I live with a condition called type 1 diabetes, which means I may sometimes need to manage my blood sugar or insulin during class.
   
   This means I may have to (explain how you manage it). I’m sharing a resource I find helpful to explain it further—here is the link.
   
   Please let me know if you have questions or would like to chat it through during office hours. Thank you so much for your consideration! I look forward to having a great semester in your class.
   
   Sincerely
   (Your Name)”
   
   Remember: this is just a template you can use as a jumping-off point. The parts in parentheses need tailoring based on your individual circumstances. If this isn’t how you write or doesn’t sound like you, customize it so it does! Make it your own. 
7. Check out The Diabetes Link, a community for teens and young adults with diabetes, and see if your campus has a chapter. 
8. If you are of the legal drinking age and anticipate that drinking will be a part of your social life, know that alcohol affects blood sugar differently than food does. When you’re navigating it for the first time, it can be especially challenging. Beyond Type 1’s Alcohol + Diabetes Guide covers how to stay safe.

College is full of firsts, and figuring out how T1D fits into campus life is one of them. The legal protections and campus resources above are there to make it easier, so use them.

Go beyond your diagnosis—download our guides that are packed with even more tips to help you succeed across life with diabetes.